Management of a metastasized high grade insulinoma (G3) with refractory hypoglycemia: case report and review of the literature.
Pancreatology
; 14(6): 542-5, 2014.
Article
en En
| MEDLINE
| ID: mdl-25459566
ABSTRACT
Insulinomas represent the most common functional neuroendocrine tumor of the pancreas. They are usually solitary, benign, well differentiated (G1/G2) and curable by surgery. We describe the case of a 45 year old male Caucasian with a unique malignant, metastasized pancreatic insulinoma (Ki 67 of 70%, G3). To control excessive insulin production emanating in refractory hypoglycemia and growth of the highly proliferating tumor a multimodal therapeutic approach including the consecutive use of tumor debulking surgery, chemotherapy, TACE, SIRT, PRRT as well as a drug therapy with diazoxide, somatostatin analogs and everolimus was employed. Chemotherapy with carboplatin/etoposide plus everolimus provided the longest normoglycemic period. After progress chemotherapy with dacarbazine had the most positive effect, while debulking approaches such as surgery and liver directed therapies, as well as PRRT were less efficient with only transient success.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Neoplasias Pancreáticas
/
Hipoglucemia
/
Insulinoma
Tipo de estudio:
Etiology_studies
Límite:
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Pancreatology
Asunto de la revista:
ENDOCRINOLOGIA
/
GASTROENTEROLOGIA
Año:
2014
Tipo del documento:
Article
País de afiliación:
Alemania